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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 355202348
Report Date: 03/12/2026
Date Signed: 03/13/2026 08:35:05 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/16/2026 and conducted by Evaluator Vadim Gorban
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20260116155846
FACILITY NAME:CLEARVIEW CAREHOMES,INC.FACILITY NUMBER:
355202348
ADMINISTRATOR:FELICIDAD RAMOS KANKELBORGFACILITY TYPE:
740
ADDRESS:3370 CIENEGA ROADTELEPHONE:
(831) 637-2139
CITY:HOLLISTERSTATE: CAZIP CODE:
95023
CAPACITY:6CENSUS: 3DATE:
03/12/2026
UNANNOUNCEDTIME BEGAN:
01:39 PM
MET WITH:Administrator, Felicidad KankelborgTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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9
Staff left residents unattended in the facility.

INVESTIGATION FINDINGS:
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On 03/12/2026, Licensing Program Analyst (LPA) V. Gorban arrived unannounced delivering findings to complaint investigation. LPA explained the purpose of the visit to facility administrator Angelica Atriano and was allowed entry.
During the course of the investigation, LPA conducted a facility tour, conducted interviews, and reviewed records.
Allegation:Staff left residents unattended in the facility. Based on interviewes and records review staff preset at the facility during all three shifts. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Report continues on attached LIC9099-A
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/16/2026 and conducted by Evaluator Vadim Gorban
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20260116155846

FACILITY NAME:CLEARVIEW CAREHOMES,INC.FACILITY NUMBER:
355202348
ADMINISTRATOR:FELICIDAD RAMOS KANKELBORGFACILITY TYPE:
740
ADDRESS:3370 CIENEGA ROADTELEPHONE:
(831) 637-2139
CITY:HOLLISTERSTATE: CAZIP CODE:
95023
CAPACITY:6CENSUS: 3DATE:
03/12/2026
UNANNOUNCEDTIME BEGAN:
01:39 PM
MET WITH:Felicidad Kankelborg, administratorTIME COMPLETED:
02:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not provide medical personnel with resident’s DNR directives.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 03/12/2026, Licensing Program Analyst (LPA) V. Gorban arrived unannounced delivering findings to complaint investigation. LPA explained the purpose of the visit to facility administrator Angelica Atriano and was allowed entry.
During the course of the investigation, LPA conducted a facility tour, conducted interviews, and reviewed records.
Allegation: Staff did not provide medical personnel with resident’s DNR directives. Based on interviews and records review medical personnel attending to R1 were not provided residents records to provide car accordingly. Based on LPAs observations and interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations being cited on the attached LIC 9099-D

Exit interview conducted, report signed and copy of this report wit appeal rights provide to administrator for facility records.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 24-AS-20260116155846
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: CLEARVIEW CAREHOMES,INC.
FACILITY NUMBER: 355202348
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/12/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/16/2026
Section Cited
CCR
87469(c)(1)
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87469 Advanced Directives and Requests Regarding Resuscitative Measures....advance directive and/or request regarding resuscitative measures form to the responding emergency medical personnel and identify the resident as the person to whom the order refers.
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The facility administrator will provide corrective measurments and POC to LPA by email following POC due date
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Based on interviews this requirement was not observed as evidensed by LPA which poses poterntial health andsafety risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3